Why does my prescription take so long to get ready?
“Just slap a label on the vial”
By Rx Clarified
Why does my prescription take so long? This is a frequent question heard in the retail pharmacy world. The question is not necessarily out of malice, but often out of curiosity. To answer this million dollar question, there are many steps involved in filling a prescription, both preceding and following “slapping a label on the vial”.
So what exactly does a pharmacist and pharmacy tech do behind the counter? Why does it take 15+ minutes sometimes to slap a label on the vial? You may be surprised to learn that there are actually many steps involved to getting you your prescription safely.
I believe it’s important for patients to have an overview of what is done behind the counter to understand the importance. As a pharmacist, I am on your side. Your health and safety is my priority and the extra time and effort I spend on your prescription is done to protect you.
Prescription Intake
The very first step to processing a prescription is intake of a prescription. A prescription can be received in a variety of means, including electronically, hard copy, faxed, verbal, and transferred. Most pharmacies have a process that involves processing prescriptions in the order they are received while also expediting urgent medications, such as antibiotics and pain medications.
To enter the prescription, a patient profile must be in the system. This is usually done by a pharmacy technician. If the patient is new to that pharmacy, a new profile will need to be created with the following info: name, date of birth, address, contact information, allergies, prescription insurance. Insurance can be one of the most time consuming processes to filling a prescription.
- Sometimes patients don’t realize their prescription insurance card is different than their medical insurance card.
- Sometimes the insurance card in their wallet is actually the old card from last year and has since expired.
- Sometime they have multiple insurance coverages (ie. Medicare and Medicaid) and forgot to bring the other card.
The prescription is in standstill until the active prescription insurance can be added into the system.
- Sometimes even when the patient has their active prescription insurance card, the prescription claim does not go through with the information on the insurance card.
(In that case, the pharmacy staff has to call the insurance plan and get the correct processing info. )
Or the dreaded scenario occurs…the prescription is not covered, which gives the patient 3 options –
- Pay out of pocket for the full cost of the medication
- Wait to see if the doctor or staff would like to submit a prior authorization to the insurance to try to get it covered
- Wait to see if the doctor is okay switching to an alternative medication that is covered
Pharmacist Check
Once the prescription is entered, a pharmacist has to check over the prescription, checking that …
- The prescription is valid and legitimate
- Dosing is safe and appropriate
(This can involve calculations based on a patient’s weight and age.) - There are no major drug interactions with any of the other medications the patient is taking
- The patient doesn’t have any potential allergies to the medication
- There is no duplicate therapy
(Duplicate therapy means the patient is already on another medication that works the same way. There are exceptions to this in certain situations, but in most cases, duplicate therapy simply leads to more risk of side effects without added benefits.)
If there’s an issue with any of the above, then the pharmacist would have to call the prescriber. Additionally, even if the medication is covered by the insurance, the patient may still have a high copay due to their insurance plan or an unmet deductible and likely will not be able to afford it, so the prescription will need to be switched to something less costly by the prescriber if possible.
Calling the doctor’s office is often the rate-limiting step. As many of you know, many doctor’s offices are understandably short-staffed especially during COVID. Not to mention, doctors are busy people, so getting a hold of them can be tough. Unfortunately, until we hear back from the doctor or the doctor’s staff, we’re not able to proceed with the prescription.
Fill & Pharmacist 2nd Check
If everything looks good with the prescription, then the technician will fill the prescription and label the vial. The labeled vial is passed to a pharmacist who then checks to make sure…
- The medication matches what was prescribed
- The patient name matches
- There aren’t any other pills mixed in
If any of those are incorrect, the prescription gets sent back to the technician to fix. Once fixed, the pharmacist will re-check to make sure everything is now a-okay.
And finally…the medication is then bagged and ready for the patient to pick up!
Seems pretty straightforward, right? It sometimes is, but keep in mind that while these steps are occurring,
- Other patients are also in line to pick up
- Some patients are here to drop off new prescriptions
- New prescriptions are being sent in electronically and via fax from the doctor’s offices
- Doctor’s offices are calling in with new prescriptions or questions
- Patients are calling in with questions or to request refills
- Patients picking up have questions for the pharmacist
- Patients are waiting for a flu shot
- Another technician has a question about typing up a prescription
Please keep in mind that some pharmacies and pharmacists have some variation to these steps or the order of these steps, but in general, this is what occurs before you’re able to leave with your medications. These steps can take some time!
